Clinical predictors of cystic fibrosis chronic rhinosinusitis severity
Anna C. Zemke MD, PhD Seyed Mehdi Nouraie MD, PhD John Moore BA Jordan R. Gaston BA Nicholas R. Rowan MD Joseph M. Pilewski MD Jennifer M. Bomberger PhD Stella E. Lee MD
First published: 04 June 2019 https://doi.org/10.1002/alr.22332
Potential conflict of interest: None disclosed.
Funding sources for the study: Cystic Fibrosis Foundation (Grant ZEMKE16Q0 to ACZ, BOMBERG14G0 to JMB and RDP Grant to JMP) NIH (K23HL131930 to ACZ, R01HL123771 to JMB, R61HL137077 to JMB, P30 DK072506 to JMP ) Gilead Investigator Sponsored Research Award to JMB, University of Pittsburgh Clinical and Translational Science Institute Pilot to JMB and SEL, supported by NIH NCATS UL1 TR0000005.
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Abstract
Background
Chronic rhinosinusitis (CRS) is a significant manifestation of cystic fibrosis (CF) with wide‐ranging symptom and disease severity. The goal of the study was to determine clinical variables that correlate with outcome measures of disease severity.
Methods
A prospective, longitudinal, observational study of 33 adults with symptomatic CRS treated in a CF‐focused otolaryngology clinic was performed. Symptom severity, the presence of rhinosinusitis exacerbations, and endoscopic appearance were assessed, and regression analysis was used to determine clinical predictors of disease outcome.
Results
Thirty‐three adults with CF‐CRS were included in the study and followed for a mean of 15 months. Rhinosinusitis exacerbations occurred in 61% of participants during the study, and female sex increased the odds of presenting with an exacerbation visit. Sinus disease exacerbations were associated with an odds ratio of 2.07 for presenting with a pulmonary exacerbation at the next visit. CF‐related diabetes was found to be associated with worse symptoms and endoscopic appearance. Infection with Staphylococcus aureus predicted worsening of symptoms, whereas infections with Pseudomonas aeruginosa improved over time. Allergic rhinitis was associated with worse endoscopic appearance, and nasal steroid use was associated with improved endoscopic appearance.
Conclusion
Sex, CF‐related diabetes, sinonasal infection status, allergic rhinitis, and nasal steroid use may all modulate severity of CF‐CRS in adults. Sinusitis exacerbation may be a precursor to pulmonary exacerbation.
Supporting Information
Anna C. Zemke MD, PhD Seyed Mehdi Nouraie MD, PhD John Moore BA Jordan R. Gaston BA Nicholas R. Rowan MD Joseph M. Pilewski MD Jennifer M. Bomberger PhD Stella E. Lee MD
First published: 04 June 2019 https://doi.org/10.1002/alr.22332
Potential conflict of interest: None disclosed.
Funding sources for the study: Cystic Fibrosis Foundation (Grant ZEMKE16Q0 to ACZ, BOMBERG14G0 to JMB and RDP Grant to JMP) NIH (K23HL131930 to ACZ, R01HL123771 to JMB, R61HL137077 to JMB, P30 DK072506 to JMP ) Gilead Investigator Sponsored Research Award to JMB, University of Pittsburgh Clinical and Translational Science Institute Pilot to JMB and SEL, supported by NIH NCATS UL1 TR0000005.
Read the full text
ePDFPDFTOOLS SHARE
Abstract
Background
Chronic rhinosinusitis (CRS) is a significant manifestation of cystic fibrosis (CF) with wide‐ranging symptom and disease severity. The goal of the study was to determine clinical variables that correlate with outcome measures of disease severity.
Methods
A prospective, longitudinal, observational study of 33 adults with symptomatic CRS treated in a CF‐focused otolaryngology clinic was performed. Symptom severity, the presence of rhinosinusitis exacerbations, and endoscopic appearance were assessed, and regression analysis was used to determine clinical predictors of disease outcome.
Results
Thirty‐three adults with CF‐CRS were included in the study and followed for a mean of 15 months. Rhinosinusitis exacerbations occurred in 61% of participants during the study, and female sex increased the odds of presenting with an exacerbation visit. Sinus disease exacerbations were associated with an odds ratio of 2.07 for presenting with a pulmonary exacerbation at the next visit. CF‐related diabetes was found to be associated with worse symptoms and endoscopic appearance. Infection with Staphylococcus aureus predicted worsening of symptoms, whereas infections with Pseudomonas aeruginosa improved over time. Allergic rhinitis was associated with worse endoscopic appearance, and nasal steroid use was associated with improved endoscopic appearance.
Conclusion
Sex, CF‐related diabetes, sinonasal infection status, allergic rhinitis, and nasal steroid use may all modulate severity of CF‐CRS in adults. Sinusitis exacerbation may be a precursor to pulmonary exacerbation.
Supporting Information
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